10A NCAC 23D .0102. OPTIONAL GROUPS

The following optional groups of individuals described by 42 U.S.C. 1396a(a)(10)(A)(ii) and 42 U.S.C. 1396a(a)(10)(C) shall be eligible for Medicaid:

(1)           Children:

(a)           Children under age one whose family income is more than the amount established under Item (16), Rule .0101 of this Section and not more than a percent of the federal poverty level established by the General Assembly;

(b)           Children under age 21 who meet the eligibility requirements of this Subchapter;

(c)           Qualified children under age 19 as described in Item (6), Rule .0101 of this Section, who were born on or before September 30, 1983, and whose income is not more than 100% of the federal poverty level;

(d)           Adopted children under age 18 with special needs, as described at 42 U.S.C. 1396a(a)(10)(A)(ii)(VIII).

(2)           Individuals receiving optional state supplemental payment.

(3)           Caretaker relatives of eligible dependent children.

(4)           Pregnant women:

(a)           Whose countable income is more than the amount established under Item (15), Rule .0101 of this Section and not more than a percent of the federal poverty level established by the General Assembly, or

(b)           Who, if their countable income exceeds the percent of the federal poverty level, established in Sub-item (4)(a) of this Rule, meet the eligibility criteria for medically needy set forth in this Subchapter.

(5)           Aged, blind and disabled individuals whose income is at or below 100% of the Federal Poverty Level, adjusted each April 1, and who meet the resource requirements of SSI, but who do not receive cash assistance.

(6)           Women, as described at 42 U.S.C. 1396a(a)(10)(A)(ii)(XVIII) who:

(a)           have been screened for breast or cervical cancer under the Centers for Disease Control and Prevention breast and cervical cancer early detection program established under Title XV of the Public Health Service Act in accordance with the requirements of section 1504 of that Act and need treatment for breast or cervical cancer, including a precancerous condition of the breast or cervix;

(b)           are not otherwise covered under creditable coverage, as defined in section 2701(c) of the Public Health Service Act;

(c)           are not otherwise eligible for Medicaid; and

(d)           have not attained age 65.

 

History Note:        Authority G.S. 108A-54; 42 C.F.R. 435.210; 42 C.F.R. 435.222; 42 C.F.R. 435.230; 42 C.F.R. 435.301; 42 C.F.R. 435.308; 42 C.F.R. 435.322; 42 C.F.R. 435.330; 42 U.S.C. 1396(a)(10)(A)(ii); 42 U.S.C. 1396a(a)(10)(C); S.L. 1983, c. 1034, s. 62.2; S.L. 1987, c. 738, s. 69 and 70; S.L. 1989, c. 752, s. 133;

Eff. September 1, 1984;

Amended Eff. February 1, 1992; July 1, 1991; August 1, 1990;

Temporary Amendment Eff. September 12, 1994, for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Temporary Amendment Eff. October 1, 1994, for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Amended Eff. January 1, 1995;

Temporary Amendment Eff. February 23, 1999;

Amended Eff. August 1, 2000;

Temporary Amendment Eff. January 1, 2002;

Amended Eff. April 1, 2003;

Transferred from 10A NCAC 21B .0102 Eff. May 1, 2012.